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Published on: March 28, 2025
Sperm Selection Using Microfluidic Techniques Significantly Decreases Sperm DNA Fragmentation (SDF), Enhancing
Alma Gisbert Iranzo1, Marina Cano-Extremera1, Irene Hervás1
1IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106-Torre A, Planta 1ª, 46026 Valencia, Spain.
Abstract:
This study aimed to compare sperm parameters and reproductive outcomes after sperm selection using microfluidic chips versus conventional techniques (swim-up/density gradients). A systematic review and meta-analysis were performed after the extraction of relevant data from thirty-nine studies that met the inclusion criteria. Mean difference or odds ratio was calculated for each outcome. The analysis revealed that sperm selection using microfluidics yields lower sperm DNA fragmentation (MD = -9.98 [-13.19, -6.76], p < 0.00001), increased progressive motility (MD = 14.50 [7.84, 21.71], p = 0.04), total motility (MD = 10.68 [6.04, 15.31], p < 0.00001) and morphology (MD = 1.41 [0.67, 2.16], p = 0.0002). Significant differences were also found in the fertilization rate/MII oocyte microinjected (OR = 1.22 [1.01, 1.46], p = 0.04), implantation rate/embryo transfer (ET) (OR = 4.51 [1.42, 14.37], p = 0.01), clinical pregnancy/ET (OR = 1.73 [1.22, 2.45], p = 0.002), ongoing pregnancy/ET (OR = 1.99 [1.03, 3.83], p = 0.04), live birth rate/first cycle (OR = 1.59 [1.12, 2.24], p = 0.009) and per all embryo transfer (OR = 1.65 [1.06, 2.55], p = 0.03). No significant differences were found in embryo euploidy/number of biopsied blastocysts (OR = 1.34 [0.88, 2.04], p = 0.77), biochemical pregnancy/ET (OR = 1.23 [0.84, 1.80], p = 0.29), miscarriage rate/cycle (OR = 0.84 [0.54, 1.31], p = 0.35) and per pregnancy (OR = 0.71 [0.50, 1.02], p = 0.07), live birth rate/first embryo transfer (OR = 1.60 [0.80, 3.22], p = 0.18) and per concluded cycle (OR = 1.03 [0.53, 2.00], p = 0.92). To summarize, microfluidics may offer a beneficial approach in certain situations, particularly for patients with elevated sperm DNA fragmentation (SDF) levels. However, its integration into routine clinical practice cannot be justified yet in terms of cost-effectiveness. Additional research is needed to provide more comprehensive data on reproductive outcomes, especially live birth rates, which remain the ultimate goal of assisted reproductive technologies.
Insights
Microfluidic chips improve sperm quality and reproductive outcomes compared to conventional methods. While beneficial for specific patients, cost-effectiveness requires further study before widespread clinical adoption.
Area of Science:
- Reproductive Medicine
- Biotechnology
- Sperm Analysis
Background:
- Sperm selection is crucial for assisted reproductive technologies (ART).
- Conventional methods like swim-up and density gradients have limitations.
- Microfluidic technology offers a novel approach to sperm selection.
Purpose of the Study:
- To compare sperm parameters and reproductive outcomes between microfluidic chips and conventional sperm selection techniques.
- To evaluate the efficacy of microfluidics in improving ART success rates.
Main Methods:
- Systematic review and meta-analysis of 39 studies.
- Comparison of sperm parameters (DNA fragmentation, motility, morphology) and reproductive outcomes (fertilization, implantation, pregnancy, live birth rates).
Main Results:
- Microfluidics significantly reduced sperm DNA fragmentation and improved progressive motility, total motility, and morphology.
- Higher rates of fertilization, implantation, clinical pregnancy, ongoing pregnancy, and live birth were observed with microfluidics.
- No significant differences were found in embryo euploidy, biochemical pregnancy, or miscarriage rates.
Conclusions:
- Microfluidic sperm selection shows promise, particularly for patients with high sperm DNA fragmentation.
- Further research is needed to confirm its cost-effectiveness and impact on live birth rates for routine clinical integration.
